Dig. Health | Dignity Health Heart and Vascular Institute Is on the Forefront of the Research, Diagnosis, and Treatment of Atrial Fibrillation

Atrial Fibrillation, a Common Heart Arrhythmia, Can Be Serious. Here’s What You Need to Know

By StoryStudio on January 24, 2024 10:06 AM

Heart arrhythmias, or irregular heart beats, represent an underdiagnosed heart condition. The term "arrhythmia" refers to any change from the normal sequence of electrical impulses in the heart, also known as the heart rhythm. Arrhythmias can affect anyone, even those who are otherwise healthy and free of other forms of heart disease. Approximately 1 in 18 people, or 5 percent of the US population, suffers from an arrhythmia. A recent study has also suggested that 1 in 4 adults over the age of 40 may develop an irregular heartbeat. “While some arrhythmias aren’t serious and resolve on their own, others can be serious or potentially life-threatening if left untreated,” says Arash Aryana, MD, PhD, FACC, FHRS, a cardiac electrophysiologist (cardiac EP) specializing in the management and treatment of heart arrhythmias at Dignity Health Heart and Vascular Institute of Greater Sacramento. “Serious cardiac arrhythmias can make the heart rate too slow, too fast, or erratic resulting in the heart pumping blood less effectively.” While heart arrhythmias have many forms, one of the most common forms is atrial fibrillation, or AFib, a type of arrhythmia that causes the upper chambers of the heart, known as the atria, to quiver and beat fast and irregularly.

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“Early detection of AFib can ensure prompt and adequate management, which not only aims at controlling the symptoms but to avoid later complications,” Dr. Aryana explains, noting that early AFib detection and management has also been shown to reduce stroke risk by more than two-thirds. It’s possible to have AFib and be asymptomatic, meaning no signs or symptoms at all. That’s why it’s important to understand the risk factors. Risk factors for AFib are myriad as researchers continue to understand this condition. What is known is that age is the number one risk, followed by heart disease, high blood pressure, diabetes, kidney disease, sleep apnea, obesity, smoking, moderate to heavy alcohol use, prolonged athletic conditioning and family history. Atrial fibrillation can be diagnosed by an electrocardiogram (ECG or EKG) or through surveillance monitoring using Holter or event monitors, ambulatory telemetry devices, implantable monitors or loop recorders. And while diagnosing AFib has been relatively straightforward, the treatment of AFib continues to advance rapidly, thanks to researchers like Dr. Aryana.

The treatment may involve medications, a treatment method to reset the heart rhythm, called cardioversion, and catheter or surgical procedures, called ablation. There are various types of cardiac ablation depending on the patient’s symptoms, overall health, and whether or not there is a need for other types of heart surgery. But the most common type is catheter ablation. Catheter ablation only takes a couple of hours and is generally an outpatient procedure, meaning that afterward, the patient is sent home on the same day. A common treatment for AFib includes blood thinner medications. In patients with AFib, the fast and chaotic heart rhythm impulses do not give the left atrium enough time to contract and squeeze the blood into the lower chambers of the heart, called the ventricles. Instead, the blood pools, promoting the formation of blood clots inside the left atrial appendage (LAA) which is a small pouch in the muscle wall of the upper chamber of the heart. Blood clots forming inside the LAA are the primary causes for stroke in patients with AFib. This is why blood thinners are prescribed to AFib patients which can help prevent major and life-threatening strokes. But in some patients, the use of blood thinners is not a good option, like those who cannot take them due to side effects or a contraindication. Instead, in those patients, a minimally invasive procedure called left atrial appendage occlusion (LAAO) can offer ideal results. Many people have heard of the WATCHMAN procedure. The WATCHMAN is a simple and widely used branded type of an LAAO device. The LAAO procedure is very safe and highly effective and there is no pain or discomfort. It usually takes less than one hour after which the patient is typically sent home the same day. Best of all, nearly all patients with AFib who receive this procedure are able to forever come off their blood thinners.

Mercy General Hospital is the highest volume LAAO center in Northern California and last year they were recognized as a Center of Excellence in performing this procedure, a distinction based on Mercy General Hospital’s excellent results and outcomes. Dignity Health Heart and Vascular Institute is at the vanguard of AFib research with experts like Dr. Aryana leading the way. Mercy General Hospital ranks in the top 7 highest volume cardiac electrophysiology laboratories in the country. It’s the #1 busiest cardiac electrophysiology facility/laboratory west of the Rockies, and the #1 highest volume cryoballoon AFib ablation program in the world. Talk to your doctor if you have risk factors for or have experienced symptoms of atrial fibrillation. If you are diagnosed with AFib, you can be confident you’re in good hands with the experts at Dignity Health Heart and Vascular Institute. Visit DignityHealth.org/HeartandVascular to learn more.

Many women ignore the warning signs of cardiovascular disease until it’s too late. By raising awareness of those signs, Dr. Singh and the team at the Women’s heart Program hope more women will take a preventative approach to heart health. "As a society, we must aim higher to overcome barriers that prevent cardiovascular survivorship in women.

AFib affects 6 million Americans, and it is estimated that this number could double by 2030. AFib also leads to more than 450,000 hospitalizations and is associated with more than 150,000 deaths each year in the US. In fact, AFib as the primary or contributing cause of death has been rising for more than two decades. “The knowledge and treatment of AFib has been heavily evolving in the last 10 to 15 years and our ability to treat it has become drastically better,” says Dr. Aryana. As the Medical Director for cardiovascular services at Dignity Health Mercy General Hospital and the Director of the Cardiac Electrophysiology Laboratory, Dr. Aryana is part of a team on the forefront of AFib research. One type of atrial fibrillation, says Dr. Aryana, is called paroxysmal AFib, which lasts less than seven days and usually stops on its own without treatment. But other forms like persistent AFib – which lasts more than seven days and typically requires treatment to restore the normal heart rhythm – and long-standing persistent AFib – which lasts more than one year and is typically difficult to treat – are more serious. Experts agree, early detection of AFib is vital, which is why clinicians like Dr. Aryana are encouraging their patients to know the warning signs and risk factors of AFib. AFib symptoms range from:

Pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath with or without chest discomfort – not all women experience chest pains! As with men, women’s most common heart attack symptom is chest pain or discomfort. But women may experience other symptoms that are typically less associated with heart attack, such as shortness of breath, nausea/vomiting and back or jaw pain. Other signs such as breaking out in a cold sweat, nausea, or lightheadedness. Mindful meditation, yoga and walking are great tools that increase self-awareness, reduce blood pressure and improve overall cardiovascular health.

The main goals of AFib treatment are to control or to reset the heartbeat and to prevent blood clots and stroke.

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Irregular or rapid heartbeat Heart palpitations (such as pounding or fluttering) Dizziness or lightheadedness Shortness of breath Chest pain/discomfort Weakness Fatigue

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